home Audience 4 Causes of aortic pulsation in the abdomen. Drug therapy. What is known about the disease

Causes of aortic pulsation in the abdomen. Drug therapy. What is known about the disease

Cardiovascular diseases occupy a leading position among the causes of mortality in modern civilized society. Even people far from medicine know what atherosclerosis, coronary heart disease, myocardial infarction, and stroke are. However, not everyone knows such a disease as aortic aneurysm. The most common aneurysms of the aorta are located in the abdominal cavity.

What is an abdominal aortic aneurysm?

The aorta is the main vessel of the body, which has the largest diameter and supplies blood to the entire body. The structure of the aorta is divided into the following sections:

ascending aorta - provides blood supply to the heart muscle;

aortic arch - carries blood to the organs of the head, neck and upper extremities;

thoracic aorta - nourishes the organs of the thoracic cavity (lungs, esophagus, trachea, diaphragm), intercostal muscles;

abdominal aorta - supplies blood to the abdominal organs, pelvis and lower extremities.

Depending on the location of the aortic section relative to renal arteries There are suprarenal (located above the renal arteries), intrarenal (at the origin of the renal arteries) and infrarenal (below the origin of the renal arteries) sections.

The term “aortic aneurysm” implies a significant expansion of its diameter. It can affect either a single section of the vessel or several sections at once until the development pathological process along its entire length. An aneurysm can form in any part of the aorta, but most often it is found in the abdominal cavity.

The walls of the aorta are strong and elastic and can withstand sudden pressure changes within enormous limits. However, with the development of an aneurysm, the tissue of the vessel may partially lose its properties. Then the weakened part of the aortic wall begins to bulge, unable to withstand the high internal pressure. If such dilation exceeds half the diameter of the normal aorta, it is called an aneurysm. Most often, the disease occurs in men over 60 years of age.

The disease may not manifest itself in any way, but there is a risk of sudden rupture of the aneurysm, in which most often it is not possible to save the patient. Aneurysm abdominal aorta ranks 15th among causes of death.

Causes of the disease

The reasons for the formation of aneurysms include:

TO additional factors development of aortic aneurysm include belonging to the white race, age, presence bad habits(smoking), arterial hypertension, atherosclerotic lesion other arterial basins.

Risks of abdominal aortic aneurysm - video

Classification

True aneurysms are direct expansion of the vessel in diameter relative to normal sizes. The shape of such aneurysms can be saccular or spindle-shaped.
False aneurysms - the aneurysm cavity fills with blood due to a defect in the aortic wall (for example, due to trauma).
Dissecting aneurysms are the sudden appearance of a defect in the aortic wall and the penetration of blood between the membranes of the vessel, as a result of which a flap of tissue is formed in its lumen.

Symptoms of an abdominal aortic aneurysm

The clinical picture of an abdominal aortic aneurysm can be different:

It is possible that there are no signs of the disease and the aneurysm is not detected by objective research(asymptomatic form).
Second option - painful sensations absent, however, the aneurysm can be identified by palpating the anterior abdominal wall as a tumor-like pulsating formation.
The third option is characterized by pain varying intensity in the abdomen, radiating to the back, lower back, sacrum. In addition, this type includes a number additional symptoms: disturbances of blood circulation in the intestines (vomiting, constipation and other disorders), renal blood flow (urinary disorders), blood supply lower limbs(intermittent claudication).

In the stage of development of complications, symptoms of threatening rupture (intense pain), rupture (clinical internal bleeding - rapid pulse, low blood pressure) and dissection.

Methods for diagnosing abdominal aneurysm

In order to put correct diagnosis, a thorough history is required (patient complaints, presence of predisposing factors, concomitant diseases and bad habits). In addition, the doctor may prescribe additional methods research:

Treatment

Do not hesitate to go to the doctor to establish an accurate diagnosis. The main method of treating aneurysms is surgery. Delay is life-threatening.

Folk remedies in the treatment of aneurysm

Effective folk remedies There is no treatment for abdominal aortic aneurysm, since it is based on a violation of the integrity of the vessel.

Medicines in the treatment of disease

Drug treatment of the aneurysm is necessary, aimed at correcting blood pressure in the aorta and treatment of concomitant diseases ( coronary disease heart, myocardial infarction, stroke). Your doctor may prescribe the following medications:

beta blockers - normalize blood pressure and pulse rate (Concor, Coronal);
ACE inhibitors (angiotensin-converting enzyme) - normalize blood pressure (Perindopril, Fosinopril);
drugs acetylsalicylic acid- improve blood fluidity, reduce the likelihood of blood clots (Aspirin, Thrombo-Ass, Aspirin-Cardio);
statins - lower cholesterol levels in the blood, prevent the formation of atherosclerotic plaques (Liprimar, Atorvastatin, Torvacard).

Surgical operations for aneurysm

Most often, the best treatment for an abdominal aneurysm is surgery. However, the choice of technique depends on the condition of the body and the presence of complications. If the aneurysm is small, the doctor may suggest watchful waiting. Availability is also taken into account possible contraindications to surgical treatment. These include:

myocardial infarction less than 3 months old;

stroke less than 6 weeks old;

pronounced changes in the lungs;

widespread atherosclerosis of the arteries of the lower extremities

In an emergency situation, i.e. when an aneurysm ruptures, there are no contraindications.

Surgical technique for resection of aneurysm

Abdominal aortic aneurysm resection involves surgical excision of the aortic aneurysm and subsequent suturing of a prosthesis. Access to the aneurysm is carried out under general anesthesia by making an incision in the abdomen midline. When the aneurysm is located below the origin of the renal vessels, the main method of operation is intrasaccular prosthetics - dissection of the affected area, sewing in a prosthesis, suturing a section of the abdominal aorta on top. It is also possible to remove the affected area of the aorta with subsequent restoration of integrity.

When the aneurysm is located above the origin of the renal vessels, prosthetics of the renal arteries is added to the main stage of the operation.

A new method of surgical treatment - endovascular implantation of a stent graft

The development of medicine and the results of technological progress have led to the development of a fundamentally new method of treating aortic aneurysms, called endoprosthetics. Stent graft - metal structure, implanted into the lumen of the aorta to strengthen its wall. The stent graft is installed through a puncture of the femoral artery using a balloon and delivery system under x-ray control. The advantages of the method include the absence of anesthesia and surgical trauma.

Possible complications

Surgery carries certain risks. According to statistics, the most common complications that arise are:

significant blood loss;

myocardial infarction;

difficulty breathing;
poor circulation in the intestines;
renal failure;
deterioration of blood supply to the lower extremities;
infection of the prosthesis.

Diet: what foods should a patient not eat?

vegetables (broccoli, beans, beans, pumpkin);
fruits (avocado, grapefruit, pomegranate);
lean meat (rabbit, turkey);
pasta from durum wheat;
wholemeal bread;
fish (salmon, trout, tuna, sardine).

Products whose consumption should be limited:

bread and pasta made from premium flour;
chocolate (except dark);
fatty meat (lamb, pork);
salo;
sweet carbonated drinks;
cream confectionery;
mayonnaise;
butter;
sausages;
hot spices.

Rehabilitation after surgery

IN postoperative period the patient has been in the department for some time intensive care. In the future, it is necessary to limit physical activity, wear a bandage, take medications prescribed by a doctor, and control cholesterol and blood pressure levels. Within dispensary observation computed tomography or magnetic resonance imaging is performed.

If any of the primary signs of an abdominal aortic aneurysm are present, you should immediately consult a specialist.

People in the older age category (over 60 years old) need to regularly visit a doctor and undergo preventive examinations. Men aged 65 to 75 who smoke should undergo an abdominal ultrasound every year. This examination is also performed for men with a family history of abdominal aneurysm.

To get checked, you need to contact a therapist, who will refer you for examinations and, if necessary, to a specialist.

Diagnosis of abdominal aortic aneurysms

How to diagnose an abdominal aortic aneurysm and is it possible to determine its possibility based on complaints? The examination algorithm looks like this:

Complaints. Paroxysmal or constant pain in the umbilical region, lower back. Episodes of hypertension, visible pulsation of the anterior abdominal wall. General state not broken. Most abdominal aortic aneurysms are asymptomatic and detected incidentally.
Inspection. Forced position with bent knees. Pallor, swelling of the legs.
Physical data. Painful palpation in the projection of the formation. Frequent soft pulse, arterial hypertension. Auscultation - vascular murmur in the projection of the aneurysm.
Laboratory examination. If the renal arteries are involved - increased creatinine levels, low urine density.
. Tachycardia and concomitant cardiac diseases are detected.
X-ray in oblique projection helps to identify limited protrusion associated with the aorta, as well as calcifications, but does not allow differential diagnosis.
Ultrasound of the abdominal aorta— “gold standard” for diagnosing aneurysms. Detect liquid round formation or diffuse dilation of the aortic lumen more than 3 cm, thinning vascular wall, parietal thrombus.
Computed tomoangiography (CTA), MRI. Expansion of the lumen and thinning of the wall of the abdominal aorta, double channel of blood flow, deformation of the contour of the renal arteries, parietal hematoma, blood clots, local edema, compression of nerve trunks. The methods are recommended for emergency diagnosis.
Transcatheter aortography. The method allows you to determine the expansion of the aortic lumen in the absence of thrombus formation. If blood clots are present, the results become false negative.

Differential diagnosis

The disease is differentiated from:

Pancreatitis;
Pancreatic cyst;
Perforation of gastric and duodenal ulcers;
Diverticulitis;
Renal colic;
Intestinal bleeding;
Colon cancer.

Comprehensive differential diagnosis performed using imaging methods - ultrasound, CT, aortography. Methods of objective and laboratory research not effective.

Treatment: choice of tactics

Therapy begins from the moment of diagnosis; tactics depend on the size of the formation. Mainly carried out surgery, however, if the aneurysm is small (up to 50 mm), the course is asymptomatic (or symptoms do not interfere full life), then the patient can be offered the method of “active waiting”, which consists of regular ultrasound examinations and monitoring the patient’s condition.

Indications for treatment without surgery:

Diameter less than 50mm;
Lack of a clinic;
Presence of contraindications to surgery;
Period of exacerbation of chronic diseases ( bronchial asthma, COPD).

Facilities drug therapy:

Beta blockers;
Statitis;
Fibrates;
Nitrates;
Aspirin;
According to indications - diuretics, ACE inhibitors.

Indications for surgery and surgical tactics

Indications for surgery:

Diameter more than 55 mm;
Presence of symptoms;
Progressive growth of more than 10 mm per year or more than 6 mm in six months;
Gap;
The appearance of daughter aneurysms;
Thrombosis;
Bag-shaped;
Intestinal ischemia;
Involvement of the renal arteries.

Relative contraindications for surgery:

Cerebral circulation disorders.

The threat of rupture is absolute indication To open surgery in all patients. In other patients, if there are contraindications, medication and symptomatic therapy, aimed at controlling the dynamics of the process, blood pressure levels, and cholesterol in the blood.

The operation is most often performed using one of two methods:

Traditional operation. During this operation the patient is under general anesthesia. The surgeon makes an incision from the urinary process of the sternum to the navel. The damaged area of the vessel is excised and implanted in its place artificial prosthesis. The procedure lasts 3-5 hours. The period of postoperative hospital stay is about a week.
Endovascular method. The procedure is usually performed using epidural anesthesia. The surgeon does small puncture in the groin area, through which, using special catheter A stent graft is applied to the aneurysm. Having brought the device to the designated location, the surgeon opens it and places it in the aneurysmal area. After the stent graft opens, a channel is formed through which normal blood flow occurs. The duration of the procedure is 3-5 hours, and postoperative hospitalization does not exceed 5 days.

Possible complications

Surgical mortality in planned patients reaches 12%, emergency – 78%.

Possible complications after surgery in case of resection of an abdominal aortic aneurysm:

Injury to the renal arteries;
Ureteral rupture;
Secondary infection;
Heart attack;

Complications during endovascular intervention occur in 1.2-5% of patients:

Stent thrombosis;
Anastomotic rupture;
Displacement of parts of the stent inside the vessel;
Secondary infection.

The prognosis is unfavorable. For small aneurysms of the abdominal aorta, the survival rate in the first year is 75%, within 5 years - 50%. If the aneurysm is larger than 6 cm, then the rates are reduced to 50% and 6%, respectively.

Primary and secondary prevention

Primary prevention is aimed at preventing the development of pathology. It includes:

Blood pressure control.
To give up smoking.
Treatment of concomitant diseases.
Elimination of stress and injury.
Maintaining a body mass index within 18.5-24.9.

Secondary prevention is aimed at slowing progression and preventing complications. It includes:

Observation by a surgeon, ultrasound - 2 times a year.
Duplex scanning - at least once a year.
Dispensary registration.
Monitoring lipid and glucose levels in the blood - 4 times a year.
Taking statins, aspirin, beta blockers and ACE inhibitors.
For patients who have undergone endovascular intervention, aortography is recommended once a year to monitor the condition of the stent.

Abdominal aortic aneurysm is an insidious and unpredictable disease. Growth cannot be predicted, so it is important to consult a specialist at the first symptoms and undergo regular medical examinations if diagnosed.

Useful video

For more details about the disease, watch the video:

An abdominal aortic aneurysm is pathological expansion the walls of this arterial vessel, which can lead to its rupture as a result of thinning. The danger of vascular disease lies in the likelihood of asymptomatic progression and death as a result of abdominal aortic dissection and subsequent bleeding.

Causes

An aneurysm is a protrusion of the walls of a vessel and its acquisition of the shape of a sac. The formation of an abdominal aortic aneurysm and the reasons that caused it are due to the influence of various factors. The main ones are:

atherosclerosis;
defect in a local area of the vascular wall;
blood pressure surges;
inflammatory processes in the aorta.

When the wall of the vessel is thinned and weakened, rupture of the abdominal aorta is possible, the causes of which are also due to the above factors.

Symptoms

Approximately ¼ of all patients diagnosed with an abdominal aortic aneurysm do not experience any symptoms of the disease. Not only are there no complaints, but examination does not always reveal signs of pathology. This course is the most dangerous, since it is not possible to control the likelihood of aneurysm rupture.

There are often cases when rupture of the aortic artery is the first manifestation of the disease. This situation is fraught with rapid death. But in most cases, the pathology can be recognized before such a complication occurs. The asymptomatic type of disease is more often detected on ultrasound or during abdominal surgery on the abdominal cavity for other pathologies.

The characteristic symptoms of an abdominal aortic aneurysm are as follows:

Pain in the groin and abdomen varying degrees severity, in most cases dull and aching. Most often localized in the mesogastrium and epigastrium. Appears after eating or physical activity. It intensifies with movement and radiates to the lower back or sacrum.
Pulsation in the abdomen. It can be intense and resemble a contraction of the heart muscle. This feeling is constantly present or renews after physical work.
Dyspeptic phenomena. Nausea, vomiting, and bloating act as secondary symptoms that appear as a result of compression of the abdominal organs.

All signs of aortic aneurysm, according to the nature of the manifestations, are combined into groups: abdominal, ischioradicular, urological.

When the aneurysm reaches big size, the blood supply to the gastrointestinal tract deteriorates, the stomach and duodenum are compressed, which manifests itself in indigestion and symptoms such as nausea, heartburn and belching, stool instability and rapid weight loss.

Ischioradic symptoms are caused by compression of the nerve roots lumbar region spine. These include:

impaired sensitivity of the skin on the legs;
feeling of numbness in the lower extremities;
intermittent claudication;
lower back pain.

Manifestations of a urological nature are provoked by compression of the ureter and displacement of the kidneys from the anatomically correct position. The patient complains of heaviness in the lumbar region and difficulty urinating. There may be blood in the urine. The possibility of developing renal colic cannot be ruled out.

Diagnostics

A set of examinations aimed at identifying an aortic aneurysm includes general examination and instrumental diagnostic methods. Pathology can be suspected by palpation and auscultation of the abdominal area. Thus, signs of a disorder are: increased pulsation, felt through the anterior abdominal wall, and systolic murmur.

The most accessible instrumental method for diagnosing the pathology in question is plain radiography. Using it, you can visualize the shadow of an aneurysm and detect pathological expansion due to calcification of the walls of this artery.

To the number modern methods refers to ultrasound with duplex scanning main artery and branches of the aorta. Ultrasound examination makes it possible to identify a defect in the vascular wall with maximum accuracy. In particular, the following parameters are determined:

the prevalence of the aneurysm and its location;
condition of the walls of the main artery;
presence and location of rupture.

It is possible to determine a rupture of an abdominal aortic aneurysm or a threatening condition using computed multislice tomography of the abdominal aorta.

Treatment

Considering that aortic rupture can occur suddenly, when it is first detected, a decision is made to remove the damaged area. Enlargement of the abdominal aorta is treated only with surgical methods.

Medication

Drug treatment Abdominal aortic aneurysm is aimed only at strengthening the walls of the artery to prevent its rupture. If the vessel contains weakness, then the aneurysm cannot disappear on its own. It will gradually stretch under the influence high pressure in the aorta. This defect can only be corrected surgically.

No medicine can reduce this pressure because it is physiologically designed and necessary for pumping blood in the body. Drug treatment is used in for preventive purposes to eliminate diseases that can weaken the walls of the aorta. In addition, for the purpose of prevention, medications are taken:

to normalize blood pressure;
to reduce blood cholesterol;
to eliminate the severity of autoimmune processes;
to control bleeding disorders;
for the treatment of chronic pathologies that are a contraindication to surgical correction aneurysms.

Surgical

Surgical treatment will allow you to completely get rid of the aneurysm by removing the defective section of the vessel. Therefore, it is impossible to do without surgery. It is performed through abdominal surgery or using endovascular surgery.

If it is possible to identify an enlargement of the aorta in the abdominal region, then the operation is carried out as planned and the patient is first prepared for the intervention. If a rupture occurs or a dissecting aneurysm is to be removed, then medical manipulation is carried out on an emergency basis.

During abdominal surgery, the abdominal wall is incised and direct access to the damaged area is provided. The deformed part is cut, and a special tube is inserted into the cavity, which will subsequently prevent rupture.

An aneurysm of any size and shape can be removed using this method.

The use of endovascular surgery allows the operation to be performed without dissecting the abdominal wall. Manipulations are carried out through the femoral artery. This method has a number of advantages over the cavity method: there is no risk of suture dehiscence and infection, a short rehabilitation period, and the blood flow in the aorta does not stop. But it is carried out only as planned, for emergency cases not suitable because it requires careful preparation of the patient.

Forecasts

Being a serious pathology, aortic aneurysm in the absence of timely medical care leads to death. This occurs as a result of rupture and massive bleeding. Since it is impossible to predict this vascular pathology, an unfavorable outcome occurs in 80% of cases.

The course of the disease and outcome are influenced by the following factors:

shape and size of the aneurysm;
reasons for education;
age of the patient;
the presence of chronic pathologies;
compliance with doctor's recommendations.

Because aneurysm is difficult to predict, people with a predisposition to the condition and a tendency to form blood clots are advised to undergo regular screening to reduce the risk of rupture. It is important to give up bad habits.

In contact with

First you need to understand what the abdominal aorta is and where it is located. This is a continuation of the thoracic aorta. Together they create the largest node on big circle circulatory system. It serves to provide nutrients and the necessary amount of oxygen to all the organs of the abdominal cavity and the network of vessels that is connected to it.

Aortic diseases can be fatal.

Features and norms

Human anatomy is considered a complex but very interesting science. Knowing what each department and organ is responsible for, how our body works, it becomes easier to monitor our health and respond to any changes in a timely manner. We can be affected by many diseases, which can only be overcome by qualified specialists. Often we are faced with diseases of organs and blood vessels directly related to them. One of them is the abdominal aorta (AA). Normally, the cross-section of this artery is 2–3 centimeters in diameter. The length does not exceed 13 cm. The BA is located in the region of the 7th spine thoracic. From there it originates and nourishes the nearby abdominal organs. It ends in the area of the 4th lumbar vertebra, after which it branches into 2 directions.

Each person may have their own characteristics and structure, which is why BA sometimes ends in the area of the 3rd or 5th lumbar vertebra. The structure allows the aorta to be protected from all kinds of damage, since it is located on inside human spine. You can find it a little to the left of the medial line. The top is covered with fiber and lymphatic vessels, which guarantees protection from damage. Located in a straight line of the aorta in early age gradually change, acquiring a curved shape.

Next to BA, a person has:

vein of the left kidney;
inferior vena cava;
pancreas;
intermesenteric plexus;
lumbar sections of the left sympathetic trunks;
upper roots of the mesentery of the intestine (small).

This aorta is directly involved in digestive process, since it provides nutrients to most organs that are responsible for digestion. In its normal state, it is characterized by a regular cylindrical shape, and when cut, the diameter is 2–3 centimeters. Any expansion, change and deviation from the norm is an impetus for examination and comprehensive diagnosis. Violation correct form leads to the development of pathologies. Detection indicates potential development dangerous diseases internal organs and systems. It is necessary to consider the most common diseases caused by disturbances in the structure of the abdominal aorta.

Common diseases

An altered diameter of the abdominal aorta, increased or decreased its size can provoke the development of a number of pathological processes. Every nearby organ is under potential threat. It is important to seek help in time for illness, to undergo ultrasound examination, that is, ultrasound of the abdominal cavity, and strictly follow the recommendations of the attending physician. Diseases are different, so each of them has its own symptoms. It is important for people to monitor their health and promptly respond to uncharacteristic and feeling unwell. An attack of abdominal pain (stomach ache) is not always a sign of banal indigestion or food poisoning.

The most common pathologies of the abdominal aorta include:

aneurysms;
atherosclerosis or thrombosis processes;
nonspecific aortitis.

When performing an ultrasound of the abdominal aorta, you need to pay attention to its condition. Some atypical changes may be observed, indicating the development of potentially dangerous diseases.

Bias. Offset compared to normal condition BA is possible with scoliosis, the formation of a retroperitoneal tumor, or with disease of the para-aortic lymph nodes. Sometimes this condition resembles the manifestation of an aneurysm, which misleads patients and treating doctors. A thorough scan will be required. To do this, the pulsation of the abdominal aorta is examined. Lymph nodes or other structures will be visually shown around or behind the BA. If an ultrasound of the abdominal aorta reveals that the cross-section has increased to 5 centimeters or more, urgent intervention will be required. Eat high probability formation of a rupture.
Narrowing. Any local narrowing requires increased attention. They need to be visualized using abdominal ultrasound in 2 different planes. This helps determine the level of prevalence of the pathological process. Narrowing can be observed along the entire length of the BA. This potentially leads to thrombosis.

Before making a final diagnosis to the patient, a comprehensive examination is carried out and the degree and nature of changes in the asthma along its entire length are identified. Only after this can treatment begin. Now let's go over the diseases characteristic of changes in the abdominal aorta.

BA aneurysm is common in humans. This is an expansion of the aorta in the area that is located between the lower branches and the aorta breast type. The expanded area is characterized by thinner walls compared to other areas, and therefore becomes the most vulnerable spot. Initially, the aneurysm does not manifest itself in any way, which does not force people to seek help. But if the situation is aggravated by external and internal factors, negative consequences begin to appear. They are expressed in the form of symptoms. With an aneurysm, a person faces:

attacks of nausea without objective reasons;
gagging:
change in the usual color of urine;
lack of blood supply to the arms and legs;
manifestation of a neoplasm in the abdominal cavity, which pulsates intensely;
pain in the lumbar area.

Each symptom appears in varying degrees intensity. This often indicates the development of a BA aneurysm. Therefore, it is necessary to quickly prepare for a visit to the clinic and. Preparation and the ultrasound examination itself involve several nuances.

You need to prepare for the study in advance. The procedure is done while you are hungry empty stomach, therefore, at least 6–7 hours should pass between the last meal and the ultrasound.
A couple of days before the procedure, stop eating foods and drinks that can cause advanced education gases in the intestines. Also exclude everything that is fatty, harmful and takes a long time to digest.
24 - 48 hours before ultrasound of the abdominal aorta, take as prescribed by your doctor. medicines, which stimulate a reduction in gas formation processes. This is especially true for people who have flatulence.
Pre-procedural preparation. Before the procedure, it is better not to drink or eat anything, chew gum or smoke. This will allow the examination to be carried out as efficiently as possible and accurate diagnosis.

The abdominal cavity must be properly prepared for examination procedures. If you do not follow the recommendations, then the doctor will not be able to get a clear picture. This will negatively affect the possible diagnosis and prescription adequate treatment. The enlarged area of BA may not withstand the excess blood pressure, losing its elasticity and bursting. The risk of rupture increases with physical, even minor, physical activity. When a rupture occurs, it enters the abdominal cavity a large number of blood. It is not always possible to save a person even in the case of surgical surgical intervention. Another potential complication of an aneurysm is the formation of blood clots in the area of swelling of the aorta. If a blood clot breaks off and begins to move along circulatory system, this can be fatal.

Not every person is predisposed to aneurysms. The risk group includes:

those suffering from hypertension;
people with connective tissue pathologies;
alcoholics and smokers;
suffered infectious diseases, which resulted in inflammation of the walls of the aorta.

Another risk factor for BA aneurysm is age. How older man, the higher the likelihood of such a pathology. But we can no longer do anything about this. We must try to lead healthy image life, give up bad habits and engage in disease prevention.

Atherosclerosis

This is a process caused by surfaces internal walls BA. An internal narrowing of the lumen occurs, and blood flow through this area is disrupted. Don't forget how important role this aorta plays a role in providing blood:

liver;
gall;
pancreas;
stomach.

Developing thrombosis of the abdominal aorta, that is, its gradual clogging, manifests itself in the form of a disrupted digestion process. The main symptoms include:

constipation (even with proper and balanced diet it cannot be avoided);
severe bloating followed by flatulence;
paroxysmal pain in the abdominal area;
diarrhea;
regular burping;
ingestion of incompletely digested food into the stool;
attacks of abdominal pain.

If the disease has progressed to severe stages, then pain in the abdominal area will continue for several hours. This is a clear reason to immediately contact specialists. By delaying the examination in the clinic, holding back the pain and trying to relieve it with painkillers, you can provoke the onset of irreversible processes. Ignoring the symptoms of asthma atherosclerosis ends chronic pathologies intestines, from which there is almost no chance to get rid of them. Atherosclerosis affecting the abdominal aorta can be treated effectively and successful treatment. Much depends on how quickly you decide to go to the doctor, conduct an examination and start complex treatment Problems. The longer you try to self-medicate or simply ignore obvious symptoms, the higher the likelihood of aggravating your condition and triggering fatal processes in the body.

Aortitis

The nonspecific form of aortitis is a dysfunction of the BA in the form of an expansion of the zone between the lower branches and thoracic aorta. In any area of the asthma, tubular expansions, asymmetrical expansions and stenosis can potentially develop. The result of stenosis is expansion and transformation into BA aneurysms. To diagnose a disorder in time, it is necessary to conduct two types of examination:

Ultrasound. Ultrasound or ultrasonography can be used to monitor possible abnormalities in the aorta. For people prone to such diseases, it is recommended to visit the ultrasound room twice a year. This allows you to observe the dynamics of changes and quickly respond to them.
Aortography. This is an alternative to echography in the absence of a clear picture of what is happening in the patient’s body.

Research and current statistics indicate a high tendency of women under 35 years of age to develop nonspecific aortitis. The disease affects patients much less often childhood. But in men, not a single case of aortitis has yet been identified. If you experience any symptoms that could potentially indicate any of the AD diseases discussed, be sure to seek professional advice. The optimal tool for confirming or refuting a diagnosis will be ultrasonography. Ultrasound provides answers to questions about the specific affected vessel, the nature of the changes and the level of deviations from the norm.

In addition to ultrasound, studies are usually prescribed to study the characteristics of vascular plaques. The procedure is not the most pleasant and can provoke painful sensations but she has high degree efficiency. It takes about 30 minutes, but after the examination you will receive an accurate diagnosis and, together with your doctor, you will be able to choose the optimal treatment tactics. Damage to the abdominal aorta causes dangerous pathologies, which cannot be ignored. Any manifestations of discomfort that do not have a logical explanation such as poisoning or indigestion are a good reason to consult a doctor and undergo an examination. The sooner changes can be detected, the less negative consequences they will bring.

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Infrarenal aortic aneurysm (that is, aortic aneurysm located below the renal arteries) is one of the most famous and common vascular diseases. With age, the risk of its occurrence becomes greater and greater. The starting point is the patient's age over 65 years, when an aneurysm can be detected in more than 5% of patients. That is why all patients of this age need to early detection aneurysms, it is necessary to undergo preventive examination. As statistical studies have shown, this approach, thanks to early treatment allowed to significantly reduce the frequency of adverse, including fatal, outcomes associated with its complicated course.

The danger of such a disease is that even with an impressive size, the aneurysm does not manifest itself clinically. The appearance of any localization usually indicates its possible complicated course. An increase in the size of the aneurysm may be accompanied by such symptoms as various dysuric disorders (impaired urination), etc., and in the presence of various “masking” concomitant diseases, the diagnosis of an abdominal aortic aneurysm may not be established in a timely manner. These are usually quite common chronic diseases, such as, for example, osteochondrosis of the lumbar spine, gastritis and, spastic colitis, and so on. And patients, unfortunately, often try to cope with these problems on their own.

Early detection of an aneurysm larger than 3.5-4 cm in diameter is an indication for surgical treatment and performing or, therefore, diagnosis of an abdominal aortic aneurysm is necessary not only for the early detection of the aneurysmal formation itself, but also for collecting diagnostic information when planning an operation.

What methods and methods of examination are usually used to diagnose aortic aneurysms?

The first point in diagnosing an abdominal aortic aneurysm is to seek advice from vascular surgeon and conducting initial medical examination. In this case, the vascular surgeon will carefully evaluate the patient’s possible complaints, find out indirect symptoms that may indicate the presence of an aneurysm, palpate the abdominal area and listen to the abdomen using a phonendoscope. Palpation rarely reveals the presence of an increase in the diameter of the aorta, but in most cases it confirms the very fact of the presence of an aneurysm when it increases by more than 4.5 - 5 cm in diameter. In this case, the aneurysm has the appearance of a voluminous, pulsating, dense formation and is often detected in the left half of the abdomen. Due to the fact that turbulent (with turbulence) blood flow occurs in the lumen of the aneurysm, vascular murmurs can be detected in the projection of the aneurysm using a phonendoscope. Determination of pulsation and auscultation in the vessels of the lower extremities, by weakening of pulsation or systolic murmurs, makes it possible to diagnose early signs atherosclerosis of the arteries of the lower extremities, which is a frequent companion to abdominal aortic aneurysms.

Fig. 1 Contours of a large aneurysm visible through the anterior abdominal wall

The simplest, fastest and most effective instrumental method diagnostics of an abdominal aortic aneurysm is an ultrasound examination (ultrasound) of the abdominal cavity, the aorta itself and its branches large arteries. In addition, this is the most accessible research method in practical medicine. vascular system. Even in the hands of a diagnostician who does not specialize in the aorta, you can always see an increase in the size of the aorta and assume the presence of an aneurysmal expansion, after which the patient can be referred for a consultation with a vascular surgeon or more an experienced doctor radiology diagnostics.

Another common method for diagnosing abdominal aortic aneurysm is computed tomography. This is now the most modern and effective method for detecting not only aneurysms, but almost any pathology of the abdominal organs. In order to distinguish vascular formations (aorta and other large vessels) from surrounding tissues, the study is carried out under conditions contrast enhancement. This study is called computed tomography with contrast().

A similar diagnostic method for studying aneurysms is MRI. Unlike CT with MRI, the computer tomograph system allows you to distinguish a vascular formation with blood circulating in it from other tissues without contrast enhancement. However, in terms of diagnosing abdominal aortic aneurysms, especially in emergency situations, MRI is less preferable due to the fact that it requires much more time to conduct the study and analyze the results. The only and an undeniable advantage MRI used in diagnosing pathology of the vascular system means that there is no need to use iodine-containing contrast agents for the enhancement effect, which is preferable when examining patients with renal failure or allergy to iodine.

Angiography is still an alternative and routine method for diagnosing abdominal aortic aneurysm. However, as a research method, it is gradually giving way to tomographic diagnostic methods. Currently, angiography for aortic aneurysms is used when it is necessary to examine the pathology of other vascular systems.
You can learn more about other methods for diagnosing abdominal aortic aneurysm and the principles of their use in the following sections of the article.